Genitourinary syndrome in postmenopausal women

Definition and presentation

This syndrome, defined in 2013, brings together a set of signs and symptoms correlated with premenopause, menopause and estrogen deficiency. This syndrome, and all the associated disorders, has a prevalence of about 50% in postmenopausal women.

The symptoms of genitourinary syndrome (GSM) are classified into 3 categories:

– urological

It includes recurrent urinary tract infections, urinary frequency and urgency and sometimes urine incontinence.

– genital

Here the main disorders are discomfort, vaginal dryness, burning, vaginal tingling and itching, bacterial and fungal infections.

– sexual

The dyspareunia related to the genitourinary syndrome is mainly due to the lack of lubrication of the mucous membranes and the atrophy that can create a stenosis of the vaginal vestibule.

Management of the genitourinary syndrome

As an objective, these 3 spheres will be taken into account to find an optimal level of comfort on a daily basis and prevent the establishment of chronic disorders. This care, beyond the possible hormone replacement therapy prescribed by the doctor, will therefore revolve around the following interventions:

Prevention of urinary tract infections

We will mention here the central role of an oral supplementation of D-Mannose associated with natural active ingredients with immunostimulant, anti-inflammatory, urine alkalinizing and muscle relaxant properties.

Support of the correct epithelialization of the bladder urothelium

The loss of trophism of the vulvovaginal mucosa is often associated with a form of “dryness” of the bladder wall that gradually loses its elastic capabilities and its protective layer of glycosaminoglycans (GAGs) that keeps it isolated from direct contact with the urine. In these conditions, it is common to experience problems such as increased urination frequency and urgency, an “intolerance” of the bladder to overfilling and an increased sensitivity to the consumption of certain drinks or foods.

Therefore, restoring a trophic urothelium makes it possible to combat these discomforts by reducing the inflammation of the wall, restoring the GAGs layer and regulating the urinary pH in favor of less acidic values.

Reduction of bladder irritation and, if present, fight against inflammation of the urinary tract

The key factor here is a management that includes: a tendentially alkaline diet, abundant and regular hydration, physiological urination (complete emptying of the bladder), elimination of alcohol and tobacco, regular intestinal transit and immune competence preservation through “good habits” (physical activity, moderate sun exposure, correct way to breathe, etc.).

As an adjuvant to these elements, certain natural anti-inflammatory active ingredients such as Morinda citrifolia and Quercetin can be used.

Hydration and support of mucosal trophism

Here we refer to the vulvovaginal mucous membranes which, due to the drop in estrogen levels, lose their natural hydration and lead to progressive atrophy causing discomfort and pain.

As in dermatology, a dry mucosa must simply be rehydrated by daily applications of a suitable cream.

Support for the correct colonization of the vulvovaginal environment by a balanced Döderlein flora

The physiological vulvo-vaginal ecosystem is made up of an abundant flora, predominantly made by lactobacilli.

The use of probiotics, both oral and local, is usually appropriate in the case of SGM.

Prevention of vaginal infections

It requires the presence of an abundant Döderlein flora, as mentioned above, and may also require local intervention to inhibit or expel potential pathogens (fungal and bacterial).

We can recommend here the use of vaginal douching or tablets that combine live Lactobacilli with D-Mannose and Lactoferrin.

Lubrication support during sexual intercourse

See this article

Support for the correct functionality of the pelvic muscles

GSM can be associated with very diverse situations in terms of pelvic tone, ranging from total relaxation to contracture. A pelvic-perineal evaluation allows us to define the situation in which we find ourselves and draw up a rehabilitation strategy in favor of toning or relaxation, depending on the case.

Prevention of neuropathies

GSM can in some cases have such an impact that occasional discomfort gradually turns into chronic pain. When this is the case, it can evolve into inflammatory situations that implement allergic processes in the tissues and damage the nerve fibers in the affected area.

The prevention and/or early management of neuropathic complications can therefore be part of the measures to be implemented, depending on the case.

Each case is unique!

We have just seen that GSM is a complex syndrome that associates several disorders. Depending on each woman, its manifestations will be diverse in nature and intensity, for which it is not possible to define a “standard” approach.

Therefore, it is recommended, if you suffer from GSM, to establish an individualized strategy (if possible accompanied by health professionals) built on the basis of the personal problem.

Many products, food supplements and medical devices, among the Deakos references, can be pointed out as useful and appropriate in the case of Genitourinary Syndrome based on the particularities and individual manifestations of the disorders.

To find out which ones are right for you, please contact us!

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